Country Court

On this page

• Overview
• Shared direction and culture
• Capable, compassionate and inclusive leaders
• Freedom to speak up
• Workforce equality, diversity and inclusion
• Governance, management and sustainability
• Partnerships and communities
• Learning, improvement and innovation

The provider did not have an effective audit and governance system in place to provide oversight of the service. There were no action plans in place to improve quality and safety within the service. This is a breach of regulation 17 of the Health and Social Care Act 2008 (Regulated Activities) 2014.

This service scored 36 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

Staff were unable to tell us what the visions and values of the service were and told us they did not feel involved in any service changes. Staff told us previously they did not attend regular team meetings; however they had just started to have them again, but they acknowledged it was a working progress.

The provider did not have any action plans in place to show the direction of the service or how it hoped to achieve changes to support the vision and values. There was no system in place to review the efficiency of the service and promote continuous learning.

Staff were not always positive when speaking about the leadership, although they did feel things were starting to improve now. They referred to a new manager and the previous registered manager had left. Comments from staff included, “The new manager is visible, I was talking to them the other day,” and “They walk around the building and ask how you are.”

The service did not have a registered manager in post. Staff were not clear about what they needed to do to improve and people, families and staff are not always informed about incidents or how the service has responded to them. Senior staff did not have the training or leadership skills which were required to lead the service and improve the quality of people’s care.

Staff told us they felt positive about the new management and would speak up if they had any concerns and felt confident, they would be listened to.

The provider had a Freedom to Speak up Policy in place and staff were aware of it.

Staff told us they had previously not been able to develop in their role. They did not feel confident they would be listened to, and their ideas would result in positive change. However, they were hoping things would improve with new management in place.

The provider had an equality and diversity policy. Previously team meetings had not been happening, staff were not given the opportunity and confidence to be able to shape the direction of the service.

Senior staff were unclear about the governance arrangements within the service. They were unable to access some of the information we required to support the inspection and acknowledged they had never been given access to this on the system. Staff told us there was no lessons learnt completed with them to improve people's care.

There were no systems and processes in place to monitor the service. Effective audits did not take place to improve the quality of the service. Care plan audits did not identify people’s changing needs and were not person centred. There was no analysis of accidents or incidents to identify themes and trends and lessons learnt. Medication audits did not identify the concerns we found on inspection. The provider had not identified any of the shortfalls we found in the service.

People told us they were assessed by occupational therapists and saw the GP if they needed. Relatives told us they would be contacted if there were any concerns about people's care.

Staff told us they worked with the occupational therapist to support people and the senior on shift would hand over any recommendations from them.

Professionals told us their recommendations were not always followed by the service. Care staff did not follow care plans or management plans that have been implemented. A professional told us staff are not meeting people’s needs and they lack the knowledge and understanding of people.

The provider did not have a system in place to review information from professionals in other organisations. Information and guidance were not transferred to care plans and staff told us they received information via a handover rather than it been documented in a care plan or risk assessment.

We found no evidence lessons had been learnt from safeguarding’s or incidents within the service. Staff told us they had not been involved in any lessons learnt. There was no strategy in place for staff development. Staff told us they have now been supported to develop their skills; however further training was required to support them to do this.

There was no process in place for learning, innovations, and improvement in the service. People and families had not been involved with the development of the service. Professionals and staff had not been asked for ideas on improvements in the service.